Provider Demographics
NPI:1134277692
Name:TIMOTHY L. GALOW, D.D.S., S.C.
Entity type:Organization
Organization Name:TIMOTHY L. GALOW, D.D.S., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GALOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-731-6545
Mailing Address - Street 1:225 N RICHMOND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4601
Mailing Address - Country:US
Mailing Address - Phone:920-731-6545
Mailing Address - Fax:
Practice Address - Street 1:225 N RICHMOND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4601
Practice Address - Country:US
Practice Address - Phone:920-731-6545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50013151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty